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Health Insurance (Expert Forum)
Please HelpGroup Coverage Through Employer
Answered by
Amir Mostafaie - health insurance, insurance
eHealthInsurance
Gold River - CA
This forum is for questions and support regarding health insurance issues such as Medicare, Medicaid, Long-term health insurance, COBRA, insurance portability.
Please HelpGroup Coverage Through Employer
by nharris28, Mar 06, 2008 07:05PM
Sir,
I have a question recently been having some medical concerns and had a bunch of tests etc, which has led to about 7 or 8 claims in the past 4 months. My employer is in the process of renewing or switching plans not to sure. However he has talked with me to make sure everything is ok and that iam doing alright but on the flip side made some comments in regards that he would like me to tell him my outcome/prognosis after further test. Iam assuming he wants to no due to the insurer raising premiums with an undiagnosed person still going through tests, or is it possible when switching plans a new insurer sees this employee with a lot of claims and not sure if i could have something that could cost them a lot of money and passes the cost on to my employer or will deny my employer group coverage due to unresolved condition. Lastly is this even legal for my employer to no how many claims i have had and to bring up this topic in the first place. Thankyou much
I have a question recently been having some medical concerns and had a bunch of tests etc, which has led to about 7 or 8 claims in the past 4 months. My employer is in the process of renewing or switching plans not to sure. However he has talked with me to make sure everything is ok and that iam doing alright but on the flip side made some comments in regards that he would like me to tell him my outcome/prognosis after further test. Iam assuming he wants to no due to the insurer raising premiums with an undiagnosed person still going through tests, or is it possible when switching plans a new insurer sees this employee with a lot of claims and not sure if i could have something that could cost them a lot of money and passes the cost on to my employer or will deny my employer group coverage due to unresolved condition. Lastly is this even legal for my employer to no how many claims i have had and to bring up this topic in the first place. Thankyou much
Doctor's Answer
by Amir Mostafaie, Mar 08, 2008 01:03AM
, Mar 08, 2008 01:03AM
To: nharris28
Dear nharris28,
Most of your assumptions could be true except the one where your employer could be denied group coverage due to your conditions. Group insurance is guaranteed issued, that means a group can not be denied health insurance due to group member’s health issues. In addition regardless of how an employee’s health issues and claims could affect the group premium rate, you are not required to disclose this type of information to your employer.
Sincerely,
Amir Mostafaie
Most of your assumptions could be true except the one where your employer could be denied group coverage due to your conditions. Group insurance is guaranteed issued, that means a group can not be denied health insurance due to group member’s health issues. In addition regardless of how an employee’s health issues and claims could affect the group premium rate, you are not required to disclose this type of information to your employer.
Sincerely,
Amir Mostafaie
